In February, President Trump signed an executive order calling for “radical transparency” in health care costs and quality. It called for “the disclosure of the actual prices of items and services, not estimates”

It is hard to exaggerate the potential importance of this order.

For decades, health care has been the largest single sector of the American economy (nearly 18 percent of gross domestic product). It has also been virtually impossible to price accurately. In fact, many insurance companies have contracts that explicitly block companies from learning what the true prices are.

I was involved years ago in a project to get an insurance company in Michigan to share its real costs with companies paying them. Even the combined power of General Motors, Ford, and Chrysler could not shake the insurance company’s determination to hide its pricing and quality information.

If you are prepared to pay cash, you can get health services and technology much cheaper than if you get it through a third-party insurance company. In one case, colonoscopies (clearly a schedulable procedure) ranged between $700 and $12,000 within a reasonable driving distance. 

There are huge savings to be had if no one ever pays $12,000 for a colonoscopy again. We could potentially get to a market in which providers compete around the $700 range (and maybe lower) once behaviors change. 

Mr. Trump began down the transparency road in his first term. The hospitals, insurance companies, and their allies in the pharmacy benefit managers (PBMs) fought with every tool in their possession to slow down and block the entire project.

Then, the Biden Administration issued orders which dramatically weakened the movement toward transparency.

Mr. Trump has learned from all these maneuvers. He is now insisting that actual prices be posted. This will create the information necessary for a true market for the first time in modern health care history.

The potential impact of this radical transparency was outlined in a letter signed by 32 economists. They wrote:

“According to JAMA, 25% of U.S. healthcare spending is administrative waste, overcharging, and fraud. Given the U.S. spends $4.5 trillion on healthcare, this analysis suggests price transparency can save the U.S. healthcare system approximately $1 trillion annually.” 

Theses savings can be achieved, they said, “by ushering in a competitive market that eliminates these inefficiencies and unnecessary middle players capitalizing on patients’ misfortune. These funds would be injected back into the U.S. economy, including through higher wages and take-home pay.”

The American people instinctively believe that transparency in cost and quality is the right policy. They know that in most of their shopping, they can learn about prices and quality before they have to make purchasing decisions. Health care is an unbelievably opaque area in which it is virtually impossible to learn true costs.

In this secret pricing system, the biggest players have the most advantage in rigging the game their way. This is one reason United Healthcare (the largest health insurance company) reported a $14.4 billion profit in 2024. Secrecy is the best friend of big systems whether they are insurance companies, hospitals, pharmacy benefit managers or others.

At America’s New Majority Project, we learned that 85 percent of Americans support laws that would strengthen price transparency so patients can shop around to save money and avoid surprise bills. 

Mr. Trump is moving in the right direction, and we must convince Congress and the bureaucracy to move toward radical transparency. This is a major step toward affordable health care, greater competition, better outcomes, lower costs, and more entrepreneurial inventiveness.

Radical transparency is also a major step toward balancing the budget. It will transfer spending from waste into capital investment and substantially increase economic growth with more jobs and a stronger economy.

As citizens, we should help Mr. Trump and Republicans make radical transparency a reality in American health care. The time has come.